Disease patterns · Advanced

Neuropathy and myopathy in the ICU

Critical illness polyneuropathy & myopathy

Find useful information despite edema, cold and limited participation.

3 learning sectionsCompiled 2026-09-08English edition · Traditional Chinese available

01Common patterns

  • CIP may reduce motor and sensory axonal responses. CIM often has low CMAPs with relatively preserved sensory responses.
  • The two can coexist, and edema or technique can also reduce sensory responses.

02Needle and specialized methods

  • When the patient can activate, MUAPs and recruitment can help assess a myopathic pattern.
  • If participation is limited, specialists may consider direct muscle stimulation and must document limitations.

03Clinical integration

  • Consider sepsis, organ failure, medication, NMJ disorders and pre-existing neuromuscular disease.
  • Weaning difficulty is multifactorial and should not be inferred from limb CMAPs alone.

Pause and explain

Explain in your own words: “CIP and CIM may coexist; classification need not be mutually exclusive.” Then think of a situation in which it could be misinterpreted.

Show a review prompt

Lack of analyzable recruitment in a sedated patient is not the same as reduced recruitment.

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References and further reading

Educational synthesis; independent neuromuscular specialist review is pending. Publication dates and compilation dates are distinct. This is an original teaching synthesis; consult the source for complete methods and criteria.